Abstract
Immunohistochemistry (IHC) is a technique whereby antigens (proteins) that are present in a cell are detected by the use of antibodies that bind to the antigens. It may be used to help make a diagnosis, provide prognostic information or to provide predictive information about how well a patient is likely to respond to treatment. IHC does not act as a replacement for histology; however, it can be used as an adjunctive investigation in selected circumstances. No immunomarker is completely sensitive and specific and therefore a panel of several markers is normally required in diagnostically challenging cases. In these circumstances, the markers are chosen at the discretion of the pathologist in order to resolve a specific dilemma, for example typing a tumour with ambiguous or poorly differentiated morphology or identifying the site of origin of a metastatic deposit. Pathologists present immunohistochemistry results in their reports and at tumour board meetings with interpretive advice. Knowledge of the principles of immunohistochemistry and its application in female genital tract tumours will help the clinician to optimise decision-making and patient care. The use of IHC in gynaecological pathology is discussed in this chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Köbel M, Rahimi K, Rambau PF, Naugler C, Le Page C, Meunier L, et al. An immunohistochemical algorithm for ovarian carcinoma typing. Int J Gynecol Pathol. 2016;35(5):430–41.
Köbel MM, McCluggage WG, Gilks CB, Singh N. Interpretation of p53 immunohistochemistry in tubo-ovarian carcinoma: guidelines for reporting. Br Assoc Gynaecol Pathol. 2016; https://www.thebagp.org/download/bagp-ukneqas-project-p53-interpretation-guide-2016/ (accessed 27.01.22)
Al-Hussaini M, Stockman A, Foster H, McCluggage WG. WT-1 assists in distinguishing ovarian from uterine serous carcinoma and in distinguishing between serous and endometrioid ovarian carcinoma. Histopathology. 2004;44(2):109–15.
Deavers MT, Malpica A, Liu J, Broaddus R, Silva EG. Ovarian sex cord-stromal tumors: an immunohistochemical study including a comparison of calretinin and inhibin. Mod Pathol. 2003;16(6):584–90.
Rabban JT, Zaloudek CJ. A practical approach to immunohistochemical diagnosis of ovarian germ cell tumours and sex cord-stromal tumours. Histopathology. 2013;62(1):71–88.
Al-Nafussi A. Ovarian epithelial tumours: common problems in diagnosis. Curr Diagn Pathol. 2004;10(6):473–99.
Chu P, Wu E, Weiss LM. Cytokeratin 7 and cytokeratin 20 expression in epithelial neoplasms: a survey of 435 cases. Mod Pathol. 2000;13(9):962–72.
Conner JR, Hornick JL. Metastatic carcinoma of unknown primary: diagnostic approach using immunohistochemistry. Adv Anat Pathol. 2015;22(3):149–67.
Ronnett BM, Shmookler BM, Diener-West M, Sugarbaker PH, Kurman RJ. Immunohistochemical evidence supporting the appendiceal origin of pseudomyxoma peritonei in women. Int J Gynecol Pathol. 1997;16(1):1–9.
McCluggage WG, Sumathi VP, McBride HA, Patterson A. A panel of immunohistochemical stains, including carcinoembryonic antigen, vimentin, and estrogen receptor, aids the distinction between primary endometrial and endocervical adenocarcinomas. Int J Gynecol Pathol. 2002;21(1):11–5.
Kounelis S, Kapranos N, Kouri E, Coppola D, Papadaki H, Jones MW. Immunohistochemical profile of endometrial adenocarcinoma: a study of 61 cases and review of the literature. Mod Pathol. 2000;13(4):379–88.
Ramalingam P, Masand RP, Euscher ED, Malpica A. Undifferentiated carcinoma of the endometrium: an expanded immunohistochemical analysis including PAX-8 and basal-like carcinoma surrogate markers. Int J Gynecol Pathol. 2016;35(5):410–8.
Cancer Genome Atlas Research Network, Kandoth C, Schultz N, Cherniack AD, Akbani R, Liu Y, et al. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497(7447):67–73.
Gilks CB, Oliva E, Soslow RA. Poor interobserver reproducibility in the diagnosis of high-grade endometrial carcinoma. Am J Surg Pathol. 2013;37(6):874–81.
Levine DA, Getz G, Gabriel SB, Cibulskis K, Lander E, Sivachenko A, et al. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497(7447):67–73.
Baretti M, Le DT. DNA mismatch repair in cancer. Pharmacol Ther. 2018;189:45–62.
Cerretelli G, Ager A, Arends MJ, Frayling IM. Molecular pathology of Lynch syndrome. J Pathol. 2020;250(5):518–31.
Stelloo E, Jansen AML, Osse EM, Nout RA, Creutzberg CL, Ruano D, et al. Practical guidance for mismatch repair-deficiency testing in endometrial cancer. Ann Oncol. 2017;28(1):96–102.
Bruegl AS, Djordjevic B, Urbauer DL, Westin SN, Soliman PT, Lu KH, et al. Utility of MLH1 methylation analysis in the clinical evaluation of Lynch Syndrome in women with endometrial cancer. Curr Pharm Des. 2014;20(11):1655–63.
Oliva E, Young RH, Amin MB, Clement PB. An immunohistochemical analysis of endometrial stromal and smooth muscle tumors of the uterus: a study of 54 cases emphasizing the importance of using a panel because of overlap in immunoreactivity for individual antibodies. Am J Surg Pathol. 2002;26(4):403–12.
McCluggage WG, Sumathi VP, Maxwell P. CD10 is a sensitive and diagnostically useful immunohistochemical marker of normal endometrial stroma and of endometrial stromal neoplasms. Histopathology. 2001;39(3):273–8.
Iwasaki S-i, Sudo T, Miwa M, Ukita M, Morimoto A, Tamada M, et al. Endometrial stromal sarcoma: clinicopathological and immunophenotypic study of 16 cases. Arch Gynecol Obstet. 2013;288(2):385–91.
Gallardo A, Prat J. Mullerian adenosarcoma: a clinicopathologic and immunohistochemical study of 55 cases challenging the existence of adenofibroma. Am J Surg Pathol. 2009;33(2):278–88.
de Leval L, Lim GSD, Waltregny D, Oliva E. Diverse phenotypic profile of uterine tumors resembling ovarian sex cord tumors: an immunohistochemical study of 12 cases. Am J Surg Pathol. 2010;34(12):1749–61.
Bennett JA, Braga AC, Pinto A, Van de Vijver K, Cornejo K, Pesci A, et al. Uterine PEComas: a morphologic, immunohistochemical, and molecular analysis of 32 tumors. Am J Surg Pathol. 2018;42(10):1370–83.
Wang EC, Kwah YC, Tan WP, Lee JS, Tan SH. Extramammary Paget disease: immunohistochemistry is critical to distinguish potential mimickers. Dermatol Online J. 2012;18(9):4.
Perrotto J, Abbott JJ, Ceilley RI, Ahmed I. The role of immunohistochemistry in discriminating primary from secondary extramammary paget disease. Am J Dermatopathol. 2010;32(2):137–43.
Mulvany NJ, Allen DG. Differentiated intraepithelial neoplasia of the vulva. Int J Gynecol Pathol. 2008;27(1):125–35.
Singh NG, Gilks CB, Wong RWC, McCluggage WG, Herrington CS. Interpretation of p16 immunohistochemistry in lower anogenital tract neoplasia. Br Assoc Gynaecol Pathol. 2019; https://www.thebagp.org/download/bagp-ukneqas-c1qc-projectinterpretation-guide-2018/ (accessed 27.01.22)
Guo M, Gong Y, Deavers M, Silva EG, Jan YJ, Cogdell DE, et al. Evaluation of a commercialized in situ hybridization assay for detecting human papillomavirus DNA in tissue specimens from patients with cervical intraepithelial neoplasia and cervical carcinoma. J Clin Microbiol. 2008;46(1):274–80.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Boyle, W., Evans, M., Vella, J. (2022). Clinical Interpretation of Immunohistochemistry in Gynaecological Cancers. In: Singh, K., Gupta, B. (eds) Gynecological Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-94110-9_15
Download citation
DOI: https://doi.org/10.1007/978-3-030-94110-9_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-94109-3
Online ISBN: 978-3-030-94110-9
eBook Packages: MedicineMedicine (R0)